Cytologie des hemopathies malignes de type myeloide a Kinshasa

Objectifs : Determiner la part de differentes entites d'hemopathies malignes myeloides et identifir leurs caracteres cytologiques et epidemiologiques. Methodes: L'etude s'est deroulee de 2004 a 2010 au sein de deux laboratoires de biologie medicale de Kinshasa. Apres la ponction medullaire a l'aiguille intramusculaire ou spinale; les frottis des patients sont colores au May Grunwald Giemsa. Les hemopathies myeloides malignes sont retenues; les variables cytologiques et epidemiologiques des patients sont etudiees. Resultats : Soixante dix neuf hemopathies malignes du tissu myeloide sont diagnostiquees sur un total de 483 malades ponctionnes. Elles sont reparties chez 52 hommes et 27 femmes. Ces hemopathies atteignent tous les ages. Leur distribution selon les tranches d'age montrait une courbe ascendante avec trois paliers : la vingtaine; la quarantaine et la soixantaine. Les entites les plus rencontrees etaient: 39;2 de leucemie myeloide chronique (LMC) et 24;1 des syndromes myelodysplasiques (SMD). La LMC predominait entre 20-39 ans ; les SMD et quelques LAM; entre 50-59 ans. Au-dela de 60 ans; on avait le grand pic des LAM et le second pic de la LMC. Conclusion : Les hemopathies malignes myeloides presentaient une tendance a l'augmentation progressive sur la duree de l'etude. Les differentes entites apparaissaient plus tot qu'a l'age decrit dans la litterature avec un taux de SMD plus important

Plasma Cell Morphology in Multiple Myeloma

Objective: To identify the different types of plasma cells in multiple myeloma. To evaluate the survival of patients according to plasma cell morphology. Method: Cytological aspects of plasma cell were examined according three criteria: the nucleolus; the chromatin and the nuclear-cellular ratio (N/C) of each plasma cell. Each plasma cell was identifid by the letter P followed by 3 digits. This identifiation allowed to classify them as immature plasma cells; intermediate plasma cells and mature plasma cells. The proportions of various plasma cells among patients; were used to determine their group of survival according to the algorithm of morphology of Goasguen. Results: Morphological aspects of plasma cells of 55 cases of multiple myeloma from 2004 to 2010 were analyzed in two laboratories in Kinshasa. The results gave the rate of eight different types of plasma cell; the rate of multiple myeloma of plasmablastic cells; increased levels of aberrant and immature plasma cells. The integration of these aberrant and immature plasma cells in the definitions of survival groups showed that the group of good responders represented 38.2 of patients. The intermediate group had 32.7. While the group of poor responders counted 29.1. Conclusion: We found a great number of aberrant and immature plasma cells. We reached that the majority of our patients were found in the intermediate group and the group of bad responders. This regrouping explains the aggressive character of the multiple myeloma among our patients